In this article, MUS is used as a prism to understand the logic of diagnostic classification in situations where medical examination does not unilaterally indicate a diagnostic category, that is, when there are no strong medical warrants for choosing one category (e.g. In other regards – such as being persisting, debilitating and widely contested conditions (Aronowitz 1998 Barker 2010 Brown 2007 Jutel 2010) – MUS differ from other ‘subjective complaints’ (e.g. This challenge is not unique to MUS: Symptoms without objective medical findings are ‘the commonest single category of complaints in general medical practice’ (Brown 2007: 773), and in that regard, MUS are typical. Diagnosing MUS therefore requires GPs ‘to make judgements on the basis of something other than purely objective medical findings, contrary to their training’ (Mik-Meyer 2014: 13). The hallmark of MUS is that medical examination yields no biomedical evidence to corroborate the patient's symptoms (cf. 2004) and explaining their condition (Hartman et al.
2013), not least because of difficulties in treating the patients (Lundh et al. Classifying MUS is challenging work that complicates doctor-patient relationships (Arrelöv et al.
Fibromyalgia and myalgic encephalomyelitis (ME) are renowned examples (cf. MUS refers to conditions that cannot be credibly established in biomedical terms and are considered unexplained by medical sciences. This article explores general practitioners’ (GPs’) perspectives on the diagnostic classification of medically unexplained symptoms (MUS). Counter to frequent descriptions as ‘illness that cannot be diagnosed’, the analysis shows how GPs can diagnose MUS in the bureaucratic sense of diagnosis as classification – a sense that has been missing from sociological view. Drawing on the distinction between diagnosis as colligation and classification, the findings and their relevance for medical sociology are discussed. The analysis suggests that GPs confer diagnoses by balancing unwarranted medical accuracy and anticipated harmful diagnostic consequences the goal of diagnosis was finding categories in the International Classification of Primary Care that would yield acceptable results, without making a liar of the GP in the process. The qualitative analysis reconstructs the logic underlying GPs’ diagnostic accounts, which centred on the meaning of diagnostic categories and on anticipating how ‘generalised others’ would respond to those meanings (called ‘diagnosing by anticipation’). The data are from three focus group interviews with Norwegian general practitioners (GPs) conducted in 2015, that centred on the issue of what diagnoses to use (or not) for MUS. Focusing on the case of medically unexplained symptoms (MUS), this article explores diagnostic classification in the absence of biomedical evidence or other strong medical warrants for diagnosis.
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